旋转-牵拉-戳按手法在外侧踝关节扭伤治疗的步态分析中的应用
Rotating-pulling-poking manipulation in gait analysis for lateral ankle sprain treatment.
作者信息
Mingshan Feng, Haibao Wen, Wenlong Zhao, Changxiao Han, Chunyu Gao, Luguang L I, Jinqiao Zou, Wuyin D U, Liguo Zhu, Jinghua Gao
机构信息
Department of Spine Surgery Ⅱ, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
Beijing Key Laboratory of Digitalized Intelligent Traditional Chinese Medicine for Prevention and Treatment of Bone and Joint Degenerative Diseases, Beijing 100102, China.
出版信息
J Tradit Chin Med. 2025 Jun;45(3):667-675. doi: 10.19852/j.cnki.jtcm.2025.03.019.
OBJECTIVE
To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation.
METHODS
Forty patients with lateral ankle sprains were randomly divided into two groups in a 1:1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment.
RESULTS
Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment ( 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment ( 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group ( 0.05).
CONCLUSIONS
The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.
目的
比较旋提拨法治疗外踝扭伤前后步态参数的变化，探讨该手法潜在的生物力学机制。
方法
采用随机数字表法将40例外踝扭伤患者按1∶1比例随机分为两组。试验组采用旋提拨法配合弹力绷带外固定治疗，对照组采用冰敷配合弹力绷带外固定治疗。两组疗程均为2周。采用三维运动捕捉系统进行运动学测量，采用Bertec步态分析测力系统进行力学测量，比较两组患者治疗前后步态参数的变化。
结果
组内比较显示，试验组患侧足支撑时间、摆动时间、后伸峰值、跖屈峰值、足趾蹬地峰值、足跟落地峰值较治疗前均有显著改善（P<0.05）。对照组患侧足摆动时间较治疗前有显著改善（P<0.05）。组间比较显示，试验组患侧足步态速度、步幅、后伸峰值、跖屈峰值、足趾蹬地峰值、足跟落地峰值均显著优于对照组（P<0.05）。
结论
旋提拨法能有效改善患者步态及患侧踝关节活动度，增强患侧足在垂直方向的负重力，以及前后方向的制动力和驱动力。这可能是旋提拨法治疗外踝扭伤的潜在生物力学机制。
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